My family dentist, who I`ll call Dr. Smith, used to do all the cleaning and routine exams by himself, but over the years his business has grown. In order to handle the large number of patients, Dr. Smith has hired a staff of dental hygienists and assistants for the routine tasks. Lately I have noticed a disturbing trend in his staffing—hygienists who are obviously not U.S. citizens.

Hygienists, doctor and dental assistants, and nurses are being imported into the U.S. by using temporary nonimmigrant guest-worker visas such as H-1B and permanent visas such as Green Cards. The medical industry "insources" these foreign workers because they don`t want to pay the going wage an American would expect. Employers also like the fact that these nonimmigrants are more "loyal" than American workers because they are essentially indentured.

I never thought Dr. Smith would resort to these hiring practices, but the allure of cheap, docile labor must have been too great for him to resist.

I arrived one morning to get a cap put on a tooth that had been bothering me. The hygienist that helped Dr. Smith was obviously an H-1B because she was Indian and had a very heavy accent. When Dr. Smith left to care for other patients, she bungled the fitting several times. Finally she had to call Dr. Smith back for help.

Previously, my wife had a similarly negative experience with two H-1Bs, one Chinese and one Indian, at the same dentist office. She complained vociferously about the same one that bungled my cap. My wife told the dentist that she will no longer tolerate being treated by those two hygienists, and later complained to me that both hygienists were incompetent H-1Bs.

Her comments shocked me because normally she avoids the topic of H-1B visas. Since her complaint, the dentist has been very careful not to allow those H-1Bs near my wife.

A year after getting that tooth worked on I appeared for another scheduled dental exam. I didn`t want a repeat performance with the H-1B so as soon as I walked up to the receptionist I handed her my www.ZaZona.com business card.

On the card is a "NO H-1B" image with the logo: "Find Out Why Offshoring and Guest-Worker Visas Destroy the American Middle Class." The receptionist took the card into the office and I noticed a few muted murmurs and perhaps some muffled laughter.

My chutzpah paid off because Dr. Smith performed the entire exam without the help of an assistant—perhaps because he didn`t have a hygienist working that day that was an American citizen. I thought the exam was one of the best I had in a long time. Dr. Smith proved that he was very good at his job when he chose to do the work himself.

I didn`t want Dr. Smith to slip with that pointy probe that he was jabbing into my gums and between my teeth. So I waited until he was finished before I queried him about his use of H-1Bs. He told me that there was a massive shortage of dental hygienists but denied that he has hired H-1Bs.

Dr. Smith hedged his answer by explaining that all of his staff is qualified to work in the United States, so I assumed he used some other visa. I ended the conversation by asking Dr. Smith if he has noticed a decline in his patients from Motorola (his office is very close to Motorola).

When he answered "yes" I told him that Motorola claims that there is a massive shortage of engineers and programmers and they use that to justify the hiring of H-1Bs. Dr. Smith was momentarily speechless as it dawned on him that he is doing the same thing as Motorola, and it`s coming back to haunt him. He awkwardly changed the subject by telling me that I need to schedule an appointment for a cracked tooth.

Epilogue: Two Weeks Later…

I arrived for my dental work and was quickly escorted into the dentist chair. Much to my surprise the H-1B hygienist was there! In my mind I debated how big of a scene I should make if she tries to touch my teeth.

She picked up some equipment, including the dreaded pointy probe, and turned towards me just long enough to give me a cold stare. She left the room in a huff. Fortunately I never saw her again. An American hygienist helped with the work and did a very good job.

I can honestly say that my dental cap was "made in America by American citizens."